Formulations of deoxycholic acid and salts thereof

ABSTRACT

The present application is directed to an aqueous pharmaceutical formulation comprising less than about 5% w/v sodium deoxycholate maintained at a pH sufficient to substantially inhibit precipitation of the sodium deoxycholate. Also disclosed herein, are methods for inhibiting precipitation of sodium deoxycholate in an aqueous solution comprising less than about 5% w/v of sodium deoxycholate, said method comprising maintaining pH of the solution of from at least about 8.0 to about 8.5.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. Ser. No. 13/323,605, filed Dec. 12, 2011; which is a continuation of U.S. Ser. No. 12/716,070, filed Mar. 2, 2010, now U.S. Pat. No. 8,101,593; which, in turn, claims the benefit under 35 U.S.C. §119(e) to U.S. provisional application Ser. No. 61/274,129 which was converted from U.S. nonprovisional application Ser. No. 12/397,229, filed Mar. 3, 2009; all of which are incorporated hereby by reference in their entirety.

FIELD OF THE INVENTION

The present invention relates to pharmaceutical formulations of acid in water wherein the formulation is maintained at a pH such that precipitation of sodium deoxycholate is substantially inhibited.

BACKGROUND

Rapid removal of body fat is an age-old ideal, and many substances have been claimed to accomplish such results, although few have shown results. “Mesotherapy,” or the use of injectables for the removal of fat, is not widely accepted among medical practitioners due to safety and efficacy concerns, although homeopathic and cosmetic claims have been made since the 1950's. Mesotherapy was originally conceived in Europe as a method of utilizing cutaneous injections containing a mixture of compounds for the treatment of local medical and cosmetic conditions. Although mesotherapy was traditionally employed for pain relief, its cosmetic applications, particularly fat and cellulite removal, have recently received attention in the United States. One such reported treatment for localized fat reduction, which was popularized in Brazil and uses injections of phosphatidylcholine, has been erroneously considered synonymous with mesotherapy. Despite its attraction as a purported “fat-dissolving” injection, the safety and efficacy of these cosmetic treatments remain ambiguous to most patients and physicians (see, Rotunda, A. M. and M. Kolodney, Dermatologic Surgery “Mesotherapy and Phosphatidylcholine Injections: Historical Clarification and Review”, 2006, 32: 465-480).

Recently published literature reports that the bile acid deoxycholic acid has fat removing properties when injected into fatty deposits in vivo (See, WO 2005/117900 and WO 2005/112942, US2005/0261258; US2005/0267080; US2006/127468; and US2006/0154906). Deoxycholate injected into fat tissue has the effects of: 1) degrading fat cells via a cytolytic mechanism; and 2) causing skin tightening. Both of these effects are required to mediate the desired aesthetic corrections (i.e., body contouring). The effects of deoxycholate into fat are spatially contained because deoxycholate injected into fat is rapidly inactivated by exposure to protein, e.g. albumin, and then rapidly returns to the intestinal contents. As a result of this attenuation effect that confers clinical safety, fat removal therapies typically require 4-6 sessions. This localized fat removal without the need for surgery is beneficial not only for therapeutic treatment relating to pathological localized fat deposits (e.g., dyslipidemias incident to medical intervention in the treatment of HIV), but also for cosmetic fat removal without the attendant risk inherent in surgery (e.g., liposuction) (see, Rotunda et al., Dermatol. Surgery “Detergent effects of sodium deoxycholate are a major feature of an injectable phosphatidylcholine formulation used for localized fat dissolution”, 2004, 30: 1001-1008; and Rotunda et al., J. Am. Acad. Dermatol. “Lipomas treated with subcutaneous deoxycholate injections”, 2005: 973-978).

All publications and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.

SUMMARY

It has been found that aqueous solutions of sodium deoxycholate at low (i.e., <5% w/v) concentrations of sodium deoxycholate can be stabilized by adjusting the pH of the solution. The present invention is directed to an aqueous pharmaceutical formulation comprising less than about 5% w/v sodium deoxycholate wherein the formulation is maintained at a pH sufficient to substantially inhibit precipitation of the sodium deoxycholate.

Also disclosed herein, are methods for inhibiting precipitation of sodium deoxycholate in an aqueous solution comprising less than about 5% w/v of sodium deoxycholate, said method comprising maintaining pH of the solution from about 8.0 to about 8.5.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A, 1B, 1C, 1D, 1E and 1F show the variability in pH over a two week period of formulations containing 5, 50, 100 and 160 mg/mL (0.5, 5, 10 and 16% w/v) sodium deoxycholate at 4° C. (FIGS. 1A, 1B and 1C) and 25° C. (FIGS. 1D, 1E and 1F).

FIGS. 2A, 2B, 2C and 2D show that solubility is independent of lot to lot variability in pH. FIG. 2A is a comparison of the 5 mg (0.5% w/v) samples tested in FIGS. 1A, 1B, 1C, 1D, 1E and 1F. FIG. 2B is a comparison of the 50 mg (5% w/v) samples tested in FIGS. 1A, 1B, 1C, 1D, 1E and 1F. FIG. 2C is a comparison of the 100 mg (10% w/v) samples tested in FIGS. 1A, 1B, 1C, 1D, 1E and 1F. FIG. 2D is a comparison of the 160 mg (16% w/v) samples tested in FIGS. 1A, 1B, 1C, 1D, 1E and 1F.

FIG. 3 shows a reverse phase HPLC chromatogram for a 20 mg/mL (2% w/v) aqueous formulation of sodium deoxycholate (0.9% NaCl and 0.9% benzyl alcohol in 10 mM phosphate buffer at a pH of 8.0) after being incubated for 2 months at 4° C.

FIG. 4 shows the effect of temperature (4° C., 25° C. and 37° C.) on the purity of various sodium deoxycholate formulations of over a two month period.

FIG. 5 shows the effect of agitation on the purity of various sodium deoxycholate formulations of over a four hour period.

FIG. 6 shows the effect of UV exposure on the purity of various sodium deoxycholate formulations of over a 24 hour period.

FIG. 7 shows the effect of five freeze-thaw cycles on the purity of various sodium deoxycholate formulations.

DETAILED DESCRIPTION

As used herein, certain terms have the following defined meanings

All numerical designations, e.g., pH, temperature, time, concentration, and molecular weight, including ranges, are approximations which are varied (+) or (−) by increments of 0.1. It is to be understood, although not always explicitly stated that all numerical designations are preceded by the term “about”. The term “about” also includes the exact value “X” in addition to minor increments of “X” such as “X+0.1” or “X−0.1.” It also is to be understood, although not always explicitly stated, that the reagents described herein are merely exemplary and that equivalents of such are known in the art.

As used herein, the term “comprising” is intended to mean that the compositions and methods include the recited elements, but do not exclude others. “Consisting essentially of” when used to define compositions and methods, shall mean excluding other elements of any essential significance to the combination when used for the intended purpose. Thus, a composition consisting essentially of the elements as defined herein would not exclude trace contaminants from the isolation and purification method and pharmaceutically acceptable carriers, such as phosphate buffered saline, preservatives, and the like. “Consisting of” shall mean excluding more than trace elements of other ingredients and substantial method steps for administering the compositions of this invention. Embodiments defined by each of these transition terms are within the scope of this invention.

As used herein, the term “sodium deoxycholate” refers to sodium (4R)-4-((3R,5R,10S,12S,13R,17R)-3,12-dihydroxy-10,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren-17-yl)pentanoate as shown below. Other stereoisomers are within the scope of the invention.

Sodium deoxycholate or sodium (4R)-4-((3R,5R,10S,12S,13R,17R)-3,12-dihydroxy-10,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren-17-yl)pentanoate can be prepared according to the methods disclosed in U.S. Patent Publication No. 2008/0318870A1 entitled “Synthetic Bile Acid Composition, Method And Preparation” filed on Feb. 21, 2008, which is hereby incorporated by reference in its entirety.

As used herein, the term “aqueous pharmaceutical formulation” refers to a formulation of sodium deoxycholate in water suitable for administration to a patient.

As used herein, the term “buffer” refers to an aqueous solution comprising a mixture of a weak acid and its conjugate base or a weak base and its conjugate acid. A buffer has the property that the pH of the solution changes very little when a small amount of acid or base is added to it. Buffer solutions are used as a means of keeping pH at a nearly constant value in a wide variety of chemical applications. Examples of suitable buffers include phosphate buffers and those known in the literature (see, for example, Troy, D. B., ed. (2005) Remington: The Science and Practice of Pharmacy, 21^(st) ed., Lippincott Williams & Wilkins).

As used herein, the term “base” refers to various typically water-soluble compounds, molecules or ions that in solution have a pH greater than 7. Such compounds, molecules or ions are able to take up a proton from an acid or are able to give up an unshared pair of electrons to an acid. Examples of suitable bases include metal carbonates and bicarbonates, for example sodium carbonate, calcium carbonate, magnesium carbonate, zinc carbonate, sodium bicarbonate and the like; and metal hydroxides, for example sodium hydroxide, potassium hydroxide, and the like, such as those known in the literature (see, for example, Troy, D. B., ed. (2005) Remington: The Science and Practice of Pharmacy, 21^(st) ed., Lippincott Williams & Wilkins).

As used herein, the term “metal carbonates” refers to the metal salt of CO₃ ²⁻. For example, sodium carbonate, calcium carbonate, magnesium carbonate, zinc carbonate, and the like.

As used herein, the term “metal bicarbonates” refers to the metal salt of HCO₃ ⁻. For example, sodium bicarbonate, and the like.

As used herein, the term “metal hydroxides” refers to the metal salt of ⁻OH. For example, sodium hydroxide, potassium hydroxide, and the like.

As used herein, the terms “sterile water” or “water for injection” refer to a sterile, nonpyrogenic preparation of water for injection which contains no bacteriostat, antimicrobial agent or added buffer. In general, the osmolar concentration of additives totals at least 112 mOsmol/liter (two-fifths of the normal osmolarity of the extracellular fluid −280 mOsmol/liter).

As used herein, the term “benzyl alcohol” refers to the compound

As used herein, the term “precipitation” refers to the formation of a solid in a solution. As used herein, the term “solution” refers to a substantially homogeneous mixture comprising two or more substances dissolved in a solvent.

As used herein, the term “substantially inhibit precipitation” means to inhibit most or all visible precipitation or maintain homogeneity. This may be done over a desired period of time.

As used herein, the term “relative standard deviation for homogeneity” or “H_(E)” refers to the value obtained by dividing the standard deviation of the homogeneity by the absolute value of the mean. An H_(E) less than 10 indicates very good homogeneity.

Formulations

Knowledge about the chemical and physical stability of a drug formulation in the desired media for delivery is valuable. In the longer term, the stability of the formulation will dictate the shelf life of the marketed product. It is preferable that the active ingredient in a pharmaceutical formulation be at the required concentration when administered to a patient.

Current methods for the administration of sodium deoxycholate to a patient include the administration of a low concentration (i.e., <5% w/v) of an aqueous solution of sodium deoxycholate, as it has been shown that the low concentration is beneficial for the effective and safe removal of fat deposits in the body. However, it has been observed that a precipitate forms at both relatively low (i.e., <5% w/v) and high (i.e., >16% w/v) concentrations of sodium deoxycholate in aqueous media. This precipitation results in a limited shelf life of aqueous solutions of sodium deoxycholate, even at cold temperatures (3-5° C.). This instability of aqueous solutions of sodium deoxycholate can be circumvented by the preparation of an aqueous solution of sodium deoxycholate at a concentration of about 5% to about 16% w/v, and having the practitioner dilute the pharmaceutical composition of sodium deoxycholate just prior to use. Whereas this dilution method is effective to allow for both storage stability and effective patient dosing, it is not ideal as a method for routine use.

It has been found that aqueous solutions of sodium deoxycholate at low (i.e., <5% w/v) concentrations of sodium deoxycholate can be stabilized adjusting the pH of the solution. The present application is directed to an aqueous pharmaceutical formulation comprising less than about 5% w/v sodium deoxycholate wherein the formulation is maintained at a pH sufficient to substantially inhibit precipitation of the sodium deoxycholate. In some embodiments, the pharmaceutical formulation, comprising less than about 5% w/v sodium deoxycholate in water, or alternatively, less than about 4.5%, or alternatively, less than about 4%, or alternatively, less than about 3.5%, or alternatively, less than about 3%, or alternatively, less than about 2.5%, or alternatively, less than about 2%, or alternatively, less than about 1.5%, or alternatively, less than about 1%, or alternatively, less than about 0.75%, or alternatively, less than about 0.5%, or alternatively, less than about 0.1% w/v sodium deoxycholate in water.

Sodium deoxycholate or sodium (4R)-4-((3R,5R,10S,12S,13R,17R)-3,12-dihydroxy-10,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren-17-yl)pentanoate can be prepared according to the methods disclosed in U.S. Patent Publication No. 2008/0318870A1 entitled “Synthetic Bile Acid Composition, Method And Preparation” filed on Feb. 21, 2008, which is hereby incorporated by reference in its entirety.

In one embodiment, the pharmaceutical formulations disclosed herein are suitable for injection into a human. The method of injection can be any type of injection, such as subcutaneous injection, as well as other forms of injection. Therefore, in some embodiments, the aqueous formulation is sterile. The aqueous formulation can be prepared using sterile water or water for injection (WFI).

In one aspect of the present invention, the precipitation of sodium deoxycholate is substantially inhibited for a period of at least about six months. In another aspect, the precipitation of sodium deoxycholate is substantially inhibited for a period of at least about one year. In yet another aspect, the precipitation of sodium deoxycholate is substantially inhibited for a period of at least about two years.

It is contemplated that when stored at various temperatures, for example at ambient or cold temperatures, the formulation can have an increased shelf life. In certain embodiments, the formulation is stored at a temperature of from about 17° C. to about 27° C. In some embodiments, the temperature of the formulation is increased to a temperature of about 25° C. to about 37° C. In other embodiments, the formulation is stored at a temperature of from about 2° C. to about 8° C.

In certain embodiments, the pH of the formulation ranges from about 8.0 to about 8.5. In one embodiment, the pH of the formulation is about 8.0, or alternatively, about 8.1, or alternatively, about 8.2, or alternatively, about 8.3, or alternatively, about 8.4, or alternatively, about 8.5.

In one embodiment, the pH is established by the use of a base. It is contemplated that any base can be used to increase the pH of the formulation provided that it does not react with the sodium deoxycholate and will not cause harm to the patient. In some embodiments, the base is selected from the group consisting of metal carbonates, metal bicarbonates, metal hydroxides, or a mixture thereof. Examples of bases include, but are not limited to, a base selected from the group consisting of sodium carbonate, calcium carbonate, magnesium carbonate, zinc carbonate, sodium bicarbonate, sodium hydroxide and potassium hydroxide or a mixture thereof. In one embodiment, the base is sodium hydroxide.

In certain cases, the pH of the formulation may be maintained with the use of a buffer. Various buffers are known in the art and it is contemplated that any buffer having buffering capacity at the desired pH can be used in the formulations disclosed herein. In one embodiment, the buffer is a phosphate buffer. The amount of phosphate in the formulation can be determined to provide a desired pH and salt concentration. In one embodiment, the formulation comprises about 10 mM phosphate.

In some embodiments, the formulation comprises at least one excipient to aid in achieving a formulation with desired properties, such as increased solubility, preservability or to provide an isotonic solution. Such excipients are known in the art. In one embodiment, the formulation comprises about 1% sodium chloride. In another embodiment, the formulation comprises about 1% benzyl alcohol. In some embodiments, the formulation comprises about 1% benzyl alcohol and about 1% sodium chloride. In some embodiments, the formulation comprises about 0.9% benzyl alcohol and about 0.9% sodium chloride.

The formulations disclosed herein comprise less than about 5% w/v sodium deoxycholate in water maintained at a pH sufficient to substantially inhibit precipitation of the sodium deoxycholate. The amount of precipitation or homogeneity of the formulation can be measured using various methods. For example, it can be measured quantitatively using light scattering by illuminating the formulation with a spectrophotometer. Or alternatively, the homogeneity can be measured qualitatively by observing the visual clarity of the solution with the eye. In some embodiments, the formulation has a relative standard deviation for homogeneity of less than about 5%. Alternatively, the formulation has a relative standard deviation for homogeneity of less than about 4%, or alternatively, about 3%, or alternatively, about 2%, or alternatively, about 1%.

The use of prodrugs of sodium deoxycholate in the formulations disclosed herein are also contemplated. A prodrug is an active or inactive compound that is modified chemically through in vivo physiological action, such as hydrolysis, metabolism and the like, into a compound of the embodiments following administration of the prodrug to a patient. For example, one may prepare an ester of the present deoxycholic acid at either or both of the hydroxyl groups thereon or of suitable derivatives thereof, so that the release of the deoxycholic acid or derivatives thereof is triggered by the disruption of the cell membrane, and release of esterase. With the release of esterase, the ester protecting group is cleaved so that the deoxycholic acid active form or derivatives thereof is present at the desired location in situ. For a general discussion of prodrugs involving esters see Svensson and Tunek Drug Metabolism Reviews 165 (1988) and Bundgaard Design of Prodrugs, Elsevier (1985).

In some embodiments, the solutions herein do not include lipids, phospholipids, or phosphatidylcholine. In some embodiments, the solutions herein include up to 5% w/w, w/v, or v/v lipids, specifically phospholipids, or more specifically phosphatidylcholine.

In some embodiments, the aqueous pharmaceutical formulation of the invention can further comprise a second therapeutic agent selected from the group consisting of: anti-microbial agents, vasoconstrictors, anti-thrombotic agents, anti-coagulation agents, suds-depressants, anti-inflammatory agents, analgesics, dispersion agents, anti-dispersion agents, penetration enhancers, steroids, tranquilizers, muscle relaxants, and anti-diarrhea agents. In some embodiments, a solution is in a container that contains up to 500 mL of solution. Such container can be a syringe or syringe-loadable container.

In some embodiments, the formulations further comprise a molecule known to cause fat to die by an orthogonal mechanism. Such molecules include neuropeptide Y (NPY) antagonists including, but not limited to, NPY receptor antagonists, such as BIBP-3226 (Amgen), BIBO-3304 (Boehringer Ingleheim), BMS-192548 and AR-H040922 (Bristol-Myers Squibb), LY-357897 (Eli Lilly), 1229U91 and GW4380145 (GlaxoSmithKline), JNJ-5207787 (Johnson & Johnson), Lu-AA-44608 (Lundbeck), MK-0557 (Merck NPY), NGD-95-1 (Neurgogen), NLX-E201 (Neurologix), CGP-71683 (Novartis), PD-160170 (Pfizer), SR-120819A, BIIE0246, and S.A.0204 (Sanofi Aventis), S-2367 (Shiongli), dihydropyridine and dihydropyridine derivatives that are NPY receptor antagonists, bicyclic compounds that are NPY receptor antagonists, carbazole NPY receptor antagonists, and tricyclic compounds that are NPY receptor antagonists (See, e.g., WO 2006/133160 and U.S. Pat. No. 6,313,128). Also contemplated are fat selective pro-apoptotic peptides such as the CKGGRAKDC peptide that homes to white fat vasculature (See, Kolonin M. G. et al., Nat. Med., 2004, 10(6): 625-32).

Another aspect of the invention relates to mixing adipo-ablative bile acids, such as, deoxycholic acid (DCA) with agents that kill fat cells. In one aspect, this invention contemplates a means to enhance the aesthetic effects of deoxycholate injections by mixing into the deoxycholate injectate a molecule that causes fat to die by an orthogonal mechanism. Examples of such candidate molecules include, but are not limited to, neuropeptide Y (NPY) antagonists and fat selective pro-apoptotic peptides. Since both fat cell killing and skin tightening may be required to mediate the desired effects, the effects of an agent with fat killing ability and potent skin tightening effects (such as deoxycholate) can be enhanced via the addition of a molecule with potent fat cell killing effects. Additionally, molecules that require access to the vasculature to kill (such as certain pro-apoptotic peptides that bind to proteins expressed on the luminal side of capillaries) can gain access to these proteins because deoxycholate may cause vascular leakage. Thus, such agents can be synergistic with deoxycholate potentially creating a more potent means to mediate body contouring in fewer therapeutic sessions.

Examples of NPY antagonists include, but are not limited to, NPY receptor antagonists, such as BIBP-3226 (Amgen), BIBO-3304 (Boehringer Ingleheim), BMS-192548 and AR-H040922 (Bristol-Myers Squibb), LY-357897 (Eli Lilly), 1229U91 and GW4380145 (GlaxoSmithKline), JNJ-5207787 (Johnson & Johnson), Lu-AA-44608 (Lundbeck), MK-0557 (Merck NPY), NGD-95-1 (Neurgogen), NLX-E201 (Neurologix), CGP-71683 (Novartis), PD-160170 (Pfizer), SR-120819A, BIIE0246, and S.A.0204 (Sanofi Aventis), S-2367 (Shiongli), dihydropyridine and dihydropyridine derivatives that are NPY receptor antagonists, bicyclic compounds that are NPY receptor antagonists, carbazole NPY receptor antagonists, and tricyclic compounds that are NPY receptor antagonists. See, e.g., WO 2006/133160 and U.S. Pat. No. 6,313,128 (incorporated herein by reference in its entirety including figures).

Exemplary fat selective pro-apoptotic peptides includes, but is not limited to, CKGGRAKDC peptide that homes to white fat vasculature. See, Kolonin M. G. et al., Nat. Med. June 10(6):625-32 (2004).

Sodium deoxycholate or sodium (4R)-4-((3R,5R,10S,12S,13R,17R)-3,12-dihydroxy-10,13-dimethylhexadecahydro-1H-cyclopenta[a]phenanthren-17-yl)pentanoate can be prepared according to the methods disclosed in U.S. Patent Publication No. 2008/0318870A1 entitled “Synthetic Bile Acid Composition, Method And Preparation” filed on Feb. 21, 2008, which is hereby incorporated by reference in its entirety. It will be appreciated that where typical or preferred process conditions (i.e., reaction temperatures, times, mole ratios of reactants, solvents, pressures, etc.) are given, other process conditions can also be used unless otherwise stated. Optimum reaction conditions may vary with the particular reactants or solvent used, but such conditions can be determined by one skilled in the art by routine optimization procedures.

Methods

Disclosed herein is a method for inhibiting precipitation of sodium deoxycholate in an aqueous solution comprising less than about 5% w/v of sodium deoxycholate, said method comprising maintaining pH of the solution from at least about 8.0 to about 8.5.

In one aspect of the present invention, methods disclosed herein substantially inhibit the precipitation of sodium deoxycholate in solution over a period of at least about six months. In another aspect, the precipitation of sodium deoxycholate is substantially inhibited for a period of at least about one year. In yet another aspect, the precipitation of sodium deoxycholate is substantially inhibited for a period of at least about two years.

It has been found that the pH of the solution can inhibit the precipitation of sodium deoxycholate at concentrations of less than about 5% w/v in water allow the sodium deoxycholate to be maintained in solution. In one embodiment, the pH is established by the use of a base. It is contemplated that any base can be used to increase the pH of the formulation provided that it does not react with the sodium deoxycholate. In some embodiments, the base is selected from the group consisting of metal carbonates, metal bicarbonates, and metal hydroxides, or a mixture thereof. Examples of bases include, but are not limited to, a base selected from the group consisting of sodium carbonate, calcium carbonate, magnesium carbonate, zinc carbonate, sodium bicarbonate, sodium hydroxide and potassium hydroxide or a mixture thereof. In one embodiment, the base is sodium hydroxide.

In certain embodiments, the pH ranges from about 8.0 to about 8.5. In one embodiment, the pH of the formulation is about 8.0, or alternatively, about 8.1, or alternatively, about 8.2, or alternatively, about 8.3, or alternatively, about 8.4, or alternatively, about 8.5. In one embodiment, the pH of the aqueous solution is about 8.3.

In certain cases, the pH of the formulation may need to be maintained with the use of a buffer. Various buffers are know in the art and it is contemplated that any buffer having buffering capacity at the desired pH can be used in the formulations disclosed herein. In one embodiment, the buffer is a phosphate buffer. The amount of phosphate required to provide a desired pH and salt concentration can be calculated using methods well known in the art. In one embodiment, the formulation comprises about 10 mM phosphate.

In one embodiment, the methods disclosed herein provide formulations which are suitable for injection into a human. The method of injection can be any type of injection, such as subcutaneous injection, as well as other forms of injection. Therefore, in some embodiments, the aqueous solution comprises sterile water or water for injection (WFI).

In one aspect, it may be that one or more excipients are used to maintain the solubility, or increase the preservability of sodium deoxycholate present in the formulation. In one embodiment, the method comprises adding about 1% benzyl alcohol. In some embodiments, the formulation also comprises at least one excipient to aid in achieving an isotonic solution. Such excipients are known in the art. In one embodiment, the method comprises adding about 1% sodium chloride. In some embodiments, the method comprises adding both 1% benzyl alcohol and 1% sodium chloride. In some embodiments, the method comprises adding both 0.9% benzyl alcohol and 0.9% sodium chloride. Using the methods disclosed herein, an aqueous solution comprising less than about 5% w/v sodium deoxycholate is maintained at a pH sufficient to substantially inhibit precipitation of the sodium deoxycholate. The amount of precipitation or homogeneity of the formulation can be measured using various methods. For example, it can be measured quantitatively by measuring the light scattering via illumination by a spectrophotometer. Or alternatively, the homogeneity can be measured qualitatively by simply observing the visual clarity of the solution with the eye. In some embodiments, the method provides a pharmaceutical formulation having a relative standard deviation for homogeneity of less than about 5%. Alternatively, the relative standard deviation for homogeneity of less than about 4%, or alternatively, about 3%, or alternatively, about 2%, or alternatively, about 1%.

The storage temperature can assist in maintaining the solubility of the sodium deoxycholate of the formulation. In certain embodiments, the storage temperature is from about 17° C. to about 27° C. In some embodiments, the storage temperature is about 25° C. to about 37° C. In other embodiments, the storage temperature is from about 2° C. to about 8° C.

It is contemplated that the sodium deoxycholate concentration can vary from about 0.05% w/v to about 5% w/v without effecting solubility in the formulation. In certain embodiments, the formulation comprises a sodium deoxycholate concentration of about 0.05% w/v. Alternatively, the formulation comprises a sodium deoxycholate concentration of about 0.07% w/v, or alternatively, about 0.1% w/v, or alternatively, about 0.3% w/v, or alternatively, about 0.5% w/v, or alternatively, about 0.7% w/v, or alternatively, about 1% w/v, or alternatively, about 2% w/v, or alternatively, about 3% w/v, or alternatively, about 4% w/v, or alternatively, about 5% w/v.

EXAMPLES

In the examples and elsewhere in the specification, abbreviations have the following meanings:

-   -   A₅₀₀=Absorbance at 500 Nanometers     -   cc=Cubic centimeter     -   CM=Centimeter     -   F/T=Freeze/Thaw     -   HPLC=High-Performance Liquid Chromatography     -   hr.=Hour     -   mg=Milligram     -   mL=Milliliter     -   mm=Millimeter     -   mM=Millimolar     -   nm=Nanometer     -   t=Time     -   UV=Ultraviolet     -   v/v=Volume/Volume     -   w/v=Weight/Volume (g/mL)     -   w/w=Weight/Weight

WFI=Water for Injection

The invention is further understood by reference to the following examples, which are intended to be purely exemplary of the invention. The present invention is not limited in scope by the exemplified embodiments, which are intended as illustrations of single aspects of the invention only. Any methods that are functionally equivalent are within the scope of the invention. Various modifications of the invention in addition to those described herein will become apparent to those skilled in the art from the foregoing description. Although several embodiments of the invention are described herein in detail, it will be understood by those skilled in the art that variations may be made thereto without departing from the spirit of the invention or the scope of the appended claims. Such modifications fall within the scope of the appended claims.

Example 1 Changes in pH and Visual Observations

This example demonstrates that aqueous formulations containing less than 5% w/v sodium deoxycholate forms a precipitate at various temperatures which cannot be brought back into solution. Solubility was best in aqueous formulations containing 5% w/v.

The stability of three lots of sodium deoxycholate dissolved in 0.9% benzyl alcohol and water for injection (WFI) was examined for changes in pH and visual observations, such as the formation of precipitate. Each lot was formulated at four concentrations: 5, 50, 100 and 160 mg/mL (0.5, 5, 10 and 16% w/v, respectively) dissolved in 0.9% benzyl alcohol and WFI. Table 1 provides a summary of the variables that were tested in this example.

TABLE 1 Experimental Variables Sample (Lot) Sodium Deoxycholate % Weight/Volume Number Concentration (mg/mL) (% w/v) 1A 5 0.5 1B 50 5 1C 100 10 1D 160 16 2A 5 0.5 2B 50 5 2C 100 10 2D 160 16 3A 5 0.5 3B 50 5 3C 100 10 3D 160 16 4 0 0

The solutions were prepared as follows. Two samples for each condition were filled at 2.0 mL into sterile 3 c.c. glass vials (West Pharma P/N 68000316), and stoppered with sterile 13 mm serum stoppers (West Pharma P/N 19560001). These samples were analyzed in duplicate at each time point in order to verify any changes in pH and visual observations, during storage at 2-8° C. and 25° C. for two weeks. Table 2 summarizes the conditions and time points at which samples were analyzed throughout the study.

TABLE 2 Conditions and Time Points Time Point Storage Conditions Analyses Analytical Methods 2-8° C.    1, 7, 14 days pH and visual observation  25° C. 0, 1, 7, 14 days pH and visual observation

As seen in Tables 3 and 4, at 5 mg/mL (0.5% w/v), fine particulates were seen generally across all lots and at both 4° C. and 25° C., though Sample 1 at 4° C. did not precipitate. At 50 mg/mL (5% w/v), all samples and conditions were clear. At 100 mg/mL (10% w/v), there was a temperature effect as all lots at 4° C. precipitated out while the 25° C. lots remained clear. At 160 mg/mL (16% w/v), there was a temperature effect as all lots at 4° C. precipitated out while the 25° C. lots remained clear. The precipitation observed at 160 mg/mL (16% w/v) was more severe and rapid than 100 mg/mL, however, the precipitated product at these two concentrations could be resolubilized after warming to room temperature and vortexing. The precipitated material at 5 mg/mL (0.5% w/v) could not be brought back into solution. This data is shown graphically in FIGS. 1A to 1F.

The pH profiles for both 4° C. and 25° C. were overlapping, so it appears that temperature did not have an impact at concentrations less than 50 mg/mL (5% w/v). Instead, there appears to be a solubility pH for formulations less than 50 mg/mL (5% w/v). At 100 and 160 mg/mL, the 4° C. samples had a higher pH than the 25° C. samples. However, with increasing concentration, temperature appears to become more important than pH, and the formulation is increasingly sensitive to temperature.

TABLE 3 pH over Time at 4° C. (Average of Two Observations) % Sample Sodium Weight/ (Lot) Deoxycholate Volume Number Concentration (% w/v) 0 days 1 day 7 days 14 days 1A 5 mg/mL 0.5 7.565 7.56  7.625 7.67 1B 50 mg/mL 5 7.885  7.905 7.95  7.965 1C 100 mg/mL 10 7.89 7.93  7.995 8   Precipi- Precipi- tate tate 1D 160 mg/mL 16 7.865 8.14  8.045  8.055 Precipi- Precipi- Precipi- tate tate tate 2A 5 mg/mL 0.5 7.62 7.53 7.6  7.66 Precipi- Precipi- Precipi- tate tate tate 2B 50 mg/mL 5 7.775  7.835  7.865 7.88 2C 100 mg/mL 10 7.77  7.845 7.98 7.93 Precipi- Precipi- Precipi- tate tate tate 2D 160 mg/mL 16 7.745 8   8.15  7.975 Precipi- Precipi- Precipi- tate tate tate 3A 5 mg/mL 0.5 7.625 7.61  7.715 7.74 Precipi- Precipi- Precipi- tate tate tate 3B 50 mg/mL 5 7.91  7.945 7.99 8   3C 100 mg/mL 10 7.905 7.97 7.99 8.01 Precipi- Precipi- tate tate 3D 160 mg/mL 16 7.86  8.115 8.15  8.065 Precipi- Precipi- Precipi- tate tate tate 4 0 0 6.945 7.08 7.13 6.87 Placebo

TABLE 4 pH over Time at 25° C. (Average of Two Observations) % Sample Sodium Weight/ (Lot) Deoxycholate Volume Number Concentration (% w/v) 0 days 1 day 7 days 14 days 1A 5 mg/mL 0.5 7.565 7.595 7.7  7.73 Precipi- Precipi- Precipi- tate tate tate 1B 50 mg/mL 5 7.885 7.95  7.95  7.98 1C 100 mg/mL 10 7.89 7.955 7.945  7.975 1D 160 mg/mL 16 7.865 7.94  7.935 7.93 2A 5 mg/mL 0.5 7.62 7.56  7.665 7.69 Precipi- Precipi- Precipi- tate tate tate 2B 50 mg/mL 5 7.775 7.845 7.865  7.885 2C 100 mg/mL 10 7.77 7.85  7.865  7.875 2D 160 mg/mL 16 7.745 7.815 7.865 7.83 3A 5 mg/mL 0.5 7.625 7.63  7.71  7.76 Precipi- Precipi- Precipi- tate tate tate 3B 50 mg/mL 5 7.91 7.955 7.985  8.015 3C 100 mg/mL 10 7.905 7.965 7.98   8.005 3D 160 mg/mL 16 7.86 7.965 7.955  7.975 4 0 0 6.945 6.825 6.945 6.93 Placebo

Table 5 shows that the solubility of sodium deoxycholate is independent of the lot to lot variability in pH. In general, there was no difference in physical stability across lots under like conditions.

TABLE 5 pH by Sample over Time Sample (Lot) % Number- Sodium Weight/ Tempera- Deoxycholate Volume ture Concentration (% w/v) 0 days 1 day 7 days 14 days 1A-4° C. 5 mg/mL 0.5 7.565 7.56 7.625 7.67 2A-4° C. 5 mg/mL 0.5 7.62 7.53 7.6 7.66 3A-4° C. 5 mg/mL 0.5 7.625 7.61 7.715 7.74 1B-4° C. 50 mg/mL 5 7.885 7.905 7.95 7.965 2B-4° C. 50 mg/mL 5 7.775 7.835 7.865 7.88 3B-4° C. 50 mg/mL 5 7.91 7.945 7.99 8 1C-4° C. 100 mg/mL 10 7.89 7.93 7.995 8 2C-4° C. 100 mg/mL 10 7.77 7.845 7.98 7.93 3C-4° C. 100 mg/mL 10 7.905 7.97 7.99 8.01 1D-4° C. 160 mg/mL 16 7.865 8.14 8.045 8.055 2D-4° C. 160 mg/mL 16 7.745 8 8.15 7.975 3D-4° C. 160 mg/mL 16 7.86 8.115 8.15 8.065 1A-25° C. 5 mg/mL 0.5 7.565 7.595 7.7 7.73 2A-25° C. 5 mg/mL 0.5 7.62 7.56 7.665 7.69 3A-25° C. 5 mg/mL 0.5 7.625 7.63 7.71 7.76 1B-25° C. 50 mg/mL 5 7.885 7.95 7.95 7.98 2B-25° C. 50 mg/mL 5 7.775 7.845 7.865 7.885 3B-25° C. 50 mg/mL 5 7.91 7.955 7.985 8.015 1C-25° C. 100 mg/mL 10 7.89 7.955 7.945 7.975 2C-25° C. 100 mg/mL 10 7.77 7.85 7.865 7.875 3C-25° C. 100 mg/mL 10 7.905 7.965 7.98 8.005 1D-25° C. 160 mg/mL 16 7.865 7.94 7.935 7.93 2D-25° C. 160 mg/mL 16 7.745 7.815 7.865 7.83 3D-25° C. 160 mg/mL 16 7.86 7.965 7.955 7.975

Three factors have been identified to contribute to solubility. In no particular order these are concentration, pH and temperature. It has been found that the lot to lot variability in pH does not account for better or poorer solubility. Overall, the 50 mg/mL seems to be the most robust condition, where all lots appear to be above the “solubility” pH, and where temperature has no impact within the two-week time frame of this study. The results suggest that concentration, pH, and storage temperature factor into the stability of sodium deoxycholate. The samples at 50 mg/mL showed the best stability at 4° C. and 25° C. for two weeks.

Example 2 Stability Study

This example demonstrates that aqueous formulations of less than 5% w/v sodium deoxycholate at a pH of 8.0 to 8.5 exhibited very good solubility. This example also demonstrates that sodium deoxycholate shows no degradation in aqueous formulations having less than 5% w/v sodium deoxycholate during storage for eight weeks at 4° C., 25° C. and 37° C. A number of formulations were subjected to agitation, UV exposure, and freeze-thaw cycles and exhibited no degradation or precipitation when exposed to those stresses.

A two-month stability study of sodium deoxycholate in several different formulations was conducted. By reverse phase HPLC, sodium deoxycholate showed no degradation in all formulations at all temperatures. However, solubility was best in formulations containing 10 mM phosphate, 0.9% NaCl, 0.9% Benzyl Alcohol at a pH of 8.0 or 8.5. Storage temperatures of 25° C. and 37° C. also assisted solubility. All formulations that were chosen for agitation, UV exposure, and freeze-thaw exhibited no degradation or precipitation when exposed to those stresses.

Table 6 provides a list of chemicals used in the preparation of the formulations disclosed herein.

TABLE 6 Chemicals used in formulation preparation Manufacturer Chemical (Product Number) Grade Benzyl Alcohol J.T. Baker (9041-01) N.F./Multi Compendial Sodium Chloride EMD Chemicals (7760) Molecular Biology Grade (99.95% pure) Sodium Hydroxide J.T. Baker (3728-01) N.F./F.C.C. Pellets Sodium Phosphate J.T. Baker (3820-01) U.S.P./F.C.C. Monobasic, Monohydrate Sorbitol EM Science (0035835B) N.F./Ph. Eur. (Extra Pure)

Stability Studies

The stability of the sodium deoxycholate formulations was examined at the conditions summarized in Table 7. Reverse phase HPLC was used along with visual observations which were conducted at each time point to monitor any precipitation or cloudiness. The formulations tested for vortex, UV exposure, and freeze-thaw, were chosen from the formulations that performed the best in the temperature study. The major stability issues of sodium deoxycholate observed during this study were solubility and pH drift.

TABLE 7 Stresses and time points Stress Conditions Time Points Temperature  4° C. 0, 2 weeks, 1 and 2 months 25° C. 0, 2 weeks, 1 and 2 months 37° C. 0, 2 weeks, 1 and 2 months Agitation Vortex  4 hours Light UV exposure 24 hours Freeze-Thaw −70° C. to 25° C.  5 cycles

i. Effect of Temperature on Stability

The formulations were incubated at 4° C., 25° C. and 37° C. and analyzed for a) degradation products, b) pH stability and c) formulation clarity.

Formulations Tested

Except for formulations only consisting of water, sodium deoxycholate was dissolved in buffer that had been titrated to a pH of 6. Each formulation, except for the two only consisting of water, was then titrated to its target pH with NaOH. All formulations were sterile filtered and filled to 1.5 mL in sterile 2 cc glass vials. The filled vials were then autoclaved. The formulations 3A and 3B were cloudy prior to filling.

TABLE 8 List of Formulations Sodium Deoxycholate % Concentration Weight/Volume Formulation Buffer Excipient(s) pH (mg/mL) (% w/v) 1A None WFI only — 20 2 WFI20 1B None WFI only — 5 0.5 WFI5 2A 10 mM 0.9% NaCl; 7.5 20 2 P7.5NB20 phosphate 0.9% Benzyl Alcohol 2B 10 mM 0.9% NaCl; 7.5 5 0.5 P7.5NB5 phosphate 0.9% Benzyl Alcohol 3A 10 mM 5% Sorbitol; 7.5 20 2 P7.5SB20 phosphate 0.9% Benzyl Alcohol 3B 10 mM 5% Sorbitol; 7.5 5 0.5 P7.5SB5 phosphate 0.9% Benzyl Alcohol 4A 10 mM 0.9% NaCl; 8.0 20 2 P8NB20 phosphate 0.9% Benzyl Alcohol 4B 10 mM 0.9% NaCl; 8.0 5 0.5 P8NB5 phosphate 0.9% Benzyl Alcohol 4C 10 mM 0.9% NaCl; 8.0 10 1 P8NB10 phosphate 0.9% Benzyl Alcohol 5 10 mM 0.9% NaCl 8.0 5 0.5 P8N5 phosphate 6A 10 mM 5% Sorbitol; 8.0 20 2 P8SB20 phosphate 0.9% Benzyl Alcohol 6B 10 mM 5% Sorbitol; 8.0 5 0.5 P8SB5 phosphate 0.9% Benzyl Alcohol 7 10 mM 5% Sorbitol 8.0 5 0.5 P8S5 phosphate 8A 10 mM 0.9% NaCl; 8.5 20 2 P8.5NB20 phosphate 0.9% Benzyl Alcohol 8B 10 mM 0.9% NaCl; 8.5 5 0.5 P8.5NB5 phosphate 0.9% Benzyl Alcohol 9A 10 mM 5% Sorbitol; 8.5 20 2 P8.5SB20 phosphate 0.9% Benzyl Alcohol 9B 10 mM 5% Sorbitol; 8.5 5 0.5 P8.5SB5 phosphate 0.9% Benzyl Alcohol

a) Degradation Products

Reverse phase HPLC was used to visualize degradation products. A sample chromatogram of formulation 4A shows the main peak with respect to the degradation products (FIG. 3). FIG. 4 shows the main peak with respect to the degradation products (i.e. Purity) for all formulations at the incubation temperatures of 4° C., 25° C. and 37° C. FIG. 4 shows the purity at t=0 and 2 months. The results suggest that no chemical degradation occurred in any of the formulations of Table 8.

b) pH Stability

Table 9 shows the pH of the formulations prior to filling and at t=0. In general, the pH drifted towards 8 and remained constant throughout the study. This suggests that sodium deoxycholate has some buffering capacity.

TABLE 9 pH Drift Formulation pH prior to fill pH at t = 0 WFI20 8.1 8.3 WFI5 7.2 7.5 P7.5NB20 7.5 7.7 P7.5NB5 7.5 7.8 P7.5SB20 7.5 7.6 P7.5SB5 7.4 7.6 P8NB20 8.0 8.3 P8NB5 8.0 8.3 P8N5 8.1 8.5 P8NB10 8.0 8.2 P8SB20 7.9 8.0 P8SB5 8.0 7.8 P8S5 8.0 7.9 P8.5NB20 8.5 8.3 P8.5NB5 8.5 8.5 P8.5SB20 8.5 8.1 P8.5SB5 8.5 8.0

c) Formulation Clarity

The clarity of each formulation was determined by two methods. One method was by visual observation, where the vial was held up to an intense light and the presence of particles was determined by what the eye could see. A set of vials filled with the formulation buffers and incubated at the three temperatures where used as reference standards. The other method used light scattering by illuminating the samples across a 1 cm path length with 500 nm light in a spectrophotometer.

The presence of visible precipitates in some formulations increased over time, particularly at 4° C. The formulations containing sorbitol at the lowest pH produced the most precipitation. The formulations that performed the best contained 10 mM phosphate, 0.9% NaCl, 0.9% Benzyl Alcohol at pH 8.0 or 8.5.

Tables 10, 11, 12 and 13 show the clarity results. The “Visual Clarity” column has a ranking system as follows: 0=clear, no particles; 1=clear, few particles; 2=clear, several particles; 3=clear, many large particles, 4=slightly cloudy; 5=very cloudy.

TABLE 10 t = 0 Formulation Visual Clarity Comments A₅₀₀ WFI20 0 0.0064 WFI5 0 0.0103 P7.5NB20 0 (gelatinous) 0.0467 P7.5NB5 0 0.0042 P7.5SB20 0 (gelatinous) 0.0405 P7.5SB5 3 Many large 0.1599 particles P8NB20 0 0.0076 P8NB5 0 0.0059 P8N5 0 0.0053 P8NB10 0 0.0038 P8SB20 0 0.0067 P8SB5 0 0.0426 P8S5 0 0.0099 P8.5NB20 0 0.0012 P8.5NB5 0 0.0048 P8.5SB20 0 0.0130 P8.5SB5 0 0.0230

TABLE 11 4° C., 2 months Visual Formulation Clarity Comments A₅₀₀ WFI20 0 −0.0006 WFI5 2 Precipitate 0.0037 P7.5NB20 0 Gelatinous −0.0001 P7.5NB5 0 −0.0036 P7.5SB20 3 Precipitate 0.0340 P7.5SB5 3 Precipitate 0.2009 P8NB20 2 Possible −0.0006 precipitate P8NB5 0 −0.0019 P8N5 1 Similar to buffer 0.0019 P8NB10 0 0.0124 P8SB20 2 Possible 0.0151 precipitate P8SB5 2 Precipitate 0.0207 P8S5 0 0.0156 P8.5NB20 0 0.0147 P8.5NB5 1 Similar to buffer 0.0156 P8.5SB20 1 Similar to buffer 0.0190 P8.5SB5 0 0.0223

TABLE 12 25° C., 2 months Visual Formulation Clarity Comments A₅₀₀ WFI20 0 0.0078 WFI5 2 Precipitate 0.0102 P7.5NB20 0 0.0081 P7.5NB5 0 0.0161 P7.5SB20 4 Precipitate 0.2129 P7.5SB5 4 Precipitate 0.1659 P8NB20 0 0.0179 P8NB5 1 Similar to buffer 0.0200 P8N5 0 0.0189 P8NB10 1 Similar to buffer 0.0161 P8SB20 0 0.0183 P8SB5 2 Possible precipitate 0.0262 P8S5 1 Similar to buffer 0.0184 P8.5NB20 0 0.0208 P8.5NB5 1 Similar to buffer 0.0195 P8.5SB20 0 0.0254 P8.5SB5 1 Similar to buffer 0.0229

TABLE 13 37° C., 2 months Visual Formulation Clarity Comments A₅₀₀ WFI20 0 0.0187 WFI5 2 Precipitate 0.0266 P7.5NB20 0 0.0196 P7.5NB5 0 0.0225 P7.5SB20 4 Precipitate 0.4785 P7.5SB5 4 Precipitate 0.6743 P8NB20 0 0.0046 P8NB5 0 −0.0016 P8N5 1 Similar to buffer 0.0047 P8NB10 0 −0.0012 P8SB20 0 0.0037 P8SB5 2 Possible 0.0195 precipitate P8S5 0 0.0086 P8.5NB20 0 0.0013 P8.5NB5 0 0.0039 P8.5SB20 0 0.0056 P8.5SB5 1 Similar to buffer 0.0040

ii. Effects of Agitation, UV Exposure, and Freeze-Thaw on Stability

Based on the results from the temperature study, the following formulations in Table 14 were chosen to test the effects of Agitation, UV Exposure, and Freeze-Thaw on stability.

TABLE 14 Agitation, UV Exposure, and Freeze - Thaw Formulations % Weight/ Concentration Volume Formulation Buffer Excipients pH (mg/mL) (% w/v) 4A 10 mM 0.9% NaCl; 8.0 20 2 P8NB20 phosphate 0.9% Benzyl Alcohol 4C 10 mM 0.9% NaCl; 8.0 10 1 P8NB10 phosphate 0.9% Benzyl Alcohol 4B 10 mM 0.9% NaCl; 8.0 5 0.5 P8NB5 phosphate 0.9% Benzyl Alcohol 8A 10 mM 0.9% NaCl; 8.5 20 2 P8.5NB20 phosphate 0.9% Benzyl Alcohol 8C 10 mM 0.9% NaCl; 8.5 10 1 P8.5NB10 phosphate 0.9% Benzyl Alcohol 8B 10 mM 0.9% NaCl; 8.5 5 0.5 P8.5NB5 phosphate 0.9% Benzyl Alcohol

a) Degradation Products

Reverse phase HPLC was used to visualize degradation products. FIGS. 5, 6 and 7 show the main peak with respect to the degradation products (i.e. Purity) for the formulations in Table 14 under the stress of agitation, UV exposure, and five freeze-thaw cycles. The results suggest that no chemical degradation occurred as a result of any of the stresses.

b) pH Stability

Table 15 shows the pH of the formulations prior to filling different than the pH's after opening the vials.

TABLE 15 pH Stability Formulation pH Prior to Fill pH at t = 0 4A 8.0 7.8 P8NB20 4C 8.0 7.9 P8NB10 4B 8.0 7.9 P8NB5 8A 8.5 8.3 P8.5NB20 8C 8.5 8.2 P8.5NB10 8B 8.5 8.1 P8.5NB5

c) Formulation Clarity

The clarity of each formulation was determined by two methods. One method was by visual observation, where the vial was held up to an intense light and the presence of particles was determined by what the eye could see. A set of vials filled with the formulation buffers and incubated at the three temperatures where used as reference standards. The other method used light scattering by illuminating the samples across a 1 cm path length with 500 nm light in a spectrophotometer.

Agitation, UV exposure, and freeze-thaw cycles does not appear to induce precipitation.

Tables 16, 17 and 18 show the clarity results. The “Visual Clarity” column has a ranking system as follows: 0=clear, no particles; 1=clear, few particles; 2=clear, several particles; 3=clear, many large particles, 4=slightly cloudy; 5=very cloudy.

TABLE 16 Agitation Visual Formulation Stress Clarity Comments A₅₀₀ 4A Control 1 Similar to 0.0023 P8NB20 buffer P8NB20 4 hr. 0 0.0068 4C Control 0 −0.0001 P8NB10 P8NB10 4 hr. 0 0.0079 4B Control 0 0.0002 P8NB5 P8NB5 4 hr. 0 0.0019 8A Control 0 −0.0002 P8.5NB20 P8.5NB20 4 hr. 0 0.0024 8C Control 1 Similar to 0.0087 P8.5NB10 buffer P8.5NB10 4 hr. 1 Similar to 0.0010 buffer 8B Control 1 Similar to 0.0029 P8.5NB5 buffer P8.5NB5 4 hr. 0 0.0022

TABLE 17 UV Exposure Visual Formulation Stress Clarity Comments A₅₀₀ 4A Control 0 0.0039 P8NB20 P8NB20 24 hr. 0 0.0023 4C Control 1 Similar to 0.0009 P8NB10 buffer P8NB10 24 hr. 1 Similar to 0.0011 buffer 4B Control 0 0.0020 P8NB5 P8NB5 24 hr. 1 Similar to 0.0017 buffer 8A Control 0 0.0046 P8.5NB20 P8.5NB20 24 hr. 0 0.0072 8C Control 1 Similar to 0.0121 P8.5NB10 buffer P8.5NB10 24 hr. 0 0.0023 8B Control 1 Similar to 0.0027 P8.5NB5 buffer P8.5NB5 24 hr. 0 0.0029

TABLE 18 Freeze - Thaw Cycles Formulation Stress Visual Clarity Comments A₅₀₀ 4A t = 0 1 Similar to buffer 0.0023 P8NB20 P8NB20 F/T 5 0 0.0084 4C t = 0 0 −0.0001 P8NB10 P8NB10 F/T 5 0 0.0064 4B t = 0 0 0.0002 P8NB5 P8NB5 F/T 5 0 0.0022 8A t = 0 0 −0.0002 P8.5NB20 P8.5NB20 F/T 5 0 0.0161 8C t = 0 1 Similar to buffer 0.0087 P8.5NB10 P8.5NB10 F/T 5 0 −0.0005 8B t = 0 1 Similar to buffer 0.0029 P8.5NB5 P8.5NB5 F/T 5 0 −0.0036

After screening the stability profile of sodium deoxycholate in seventeen unique formulations, it was determined that formulations containing 10 mM Phosphate, 0.9% NaCl and 0.9% Benzyl Alcohol at pH 8.0 or 8.5 best prevented visible precipitation in addition to maximizing solubility. By reverse phase HPLC, sodium deoxycholate shows no degradation in all formulations at all temperatures, during storage for eight weeks at 4° C., 25° C. and 37° C. As far as visual clarity of formulations, storage temperatures of 25° C. and 37° C. actually improved the solubility of sodium deoxycholate as compared to 4° C.

All formulations that were chosen for agitation, UV exposure, and freeze-thaw exhibited no degradation or precipitation when exposed to those stresses. Upon completion of the eight week storage stability study, selected formulations were subjected to these acute stress conditions. These experiments help determine the stability of sodium deoxycholate during the stress of common manufacturing and shipping procedures. The data obtained from these acute stress studies confirm the stability of sodium deoxycholate in formulations containing 10 mM Phosphate, 0.9% NaCl and 0.9% Benzyl Alcohol at pH 8.0 or 8.5, with sodium deoxycholate concentration of 5, 10 and 20 mg/mL. 

1. An aqueous pharmaceutical formulation comprising less than about 5% w/v sodium deoxycholate wherein the formulation is maintained at a pH sufficient to substantially inhibit precipitation of the sodium deoxycholate.
 2. The formulation of claim 1, wherein the precipitation of sodium deoxycholate is substantially inhibited for a period of at least about six months. 3-9. (canceled)
 10. The formulation of claim 1, wherein the aqueous formulation is sterile.
 11. The formulation of claim 1, further comprising about 1% benzyl alcohol.
 12. The formulation of claim 1, further comprising about 1% sodium chloride.
 13. The formulation of claim 1, wherein the pH is from about 8.0 to about 8.5.
 14. The formulation of claim 13, wherein the pH is at least about 8.3.
 15. The formulation of claim 1, wherein the aqueous pharmaceutical formulation has a relative standard deviation for homogeneity of less than about 5%. 16-17. (canceled)
 18. The formulation of claim 1, wherein the formulation is suitable for injection into a human.
 19. An aqueous pharmaceutical formulation comprising less than about 5% w/v sodium deoxycholate in water maintained at a pH of about 8.3.
 20. A method for inhibiting precipitation of sodium deoxycholate in an aqueous solution comprising less than about 5% w/v of sodium deoxycholate, said method comprising maintaining pH of the solution from about 8.0 to about 8.5.
 21. The method of claim 20, wherein the precipitation of sodium deoxycholate is substantially inhibited for a period of at least about six months. 22-29. (canceled)
 30. The method of claim 20, wherein the aqueous solution further comprises about 1% benzyl alcohol.
 31. The method of claim 20, wherein the aqueous solution further comprises about 1% sodium chloride.
 32. The method of claim 20, wherein the aqueous solution has a pH from about 8.0 to about 8.5.
 33. The method of claim 32, wherein the aqueous solution has a pH of at least about 8.3.
 34. The method of claim 20, wherein the sodium deoxycholate in solution has a relative standard deviation for homogeneity of less than about 5%. 35-36. (canceled)
 37. The method of claim 20, wherein the aqueous solution comprises a sodium deoxycholate concentration from about 0.05% w/v to about 5% w/v. 